Korean J Intern Med.  1997 Jan;12(1):1-6.

Preoperative evaluation of the curative resectability of gastric cancer by abdominal computed tomography and ultrasonography: a prospective comparison study

• Kim JJ
• Jung HC
• Song IS
• Choi KW
• Kim CY
• Han JK
• Choi BI
• Park JG
• Lee KU
• Choe KJ
• Kim WH

Abstract

OBJECTIVES
We compared the ability of preoperative abdominal computed tomography (CT) with that of preoperative abdominal ultrasonography (US) in predicting the extent of tumor growth and the curative resectability of gastric cancer. METHODS: Abdominal CT and US were done in 95 patients with gastric adeno-carcinoma. The radiologic findings were prospectively compared with surgical and pathologic findings. RESULTS: The sensitivities of abdominal CT and US in detecting the perigastric lymph node involvement were 26.6% and 20%, respectively. The sensitivity of abdominal CT in predicting the pancreatic invasion (60%) was better than that of abdominal US (20%). However, there were 6 false positive diagnosis of pancreatic invasion by abdominal CT; in contrast, there was no false positive diagnosis of pancreatic invasion by abdominal US. Of 95 patients who underwent surgical exploration, 14 were found to have unresectable tumors because of extragastric organ involvement and distant metastases. Abdominal CT falsely predicted 8 of 14 cases in which curative gastric resection was impossible as resectable. Moreover, abdominal CT falsely predicted 5 of 81 cases in which curative gastric resection was possible as unresectable. Abdominal US falsely predicted 12 of 14 cases in which curative surgery was impossible as resectable. CONCLUSION: Preoperative abdominal Ct and US did not accurately predict the tumor extent and the curative resectability of the gastric cancer. Especially, abdominal CT finding of pancreatic invasion by gastric cancer should not be a contraindication for surgical exploration.

MeSH Terms

MeSH Terms:
Abdomen/ultrasonography
Abdomen/radiography
Adenocarcinoma/surgery*
Adenocarcinoma/secondary
Adenocarcinoma/diagnosis*
Adult
Aged
Colonic Neoplasms/ultrasonography
Colonic Neoplasms/secondary
Colonic Neoplasms/radiography
Comparative Study
Female
Gastrectomy
Human
Liver Neoplasms/ultrasonography
Liver Neoplasms/secondary
Liver Neoplasms/radiography
Lymphatic Metastasis/ultrasonography
Lymphatic Metastasis/radiography
Male
Middle Age
Pancreatic Neoplasms/secondary
Pancreatic Neoplasms/radiography
Peritoneal Neoplasms/ultrasonography
Peritoneal Neoplasms/secondary
Peritoneal Neoplasms/radiography
Peritoneal Neoplasms/radiography
Predictive Value of Tests
Preoperative Care
Prospective Studies
Sensitivity and Specificity
Stomach Neoplasms/surgery*
Stomach Neoplasms/diagnosis*